Physical, cognitive, and mental health impacts of Omicron reinfection in patients with original SARS-CoV-2 infection: a community-based observational study.

Abstract

Background: Epidemiological and clinical evidence suggests that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) reinfection is a complication in a proportion of patients reporting ongoing health issues. However, most studies in the field of SARS-CoV-2 reinfection have focused only on self-reported symptoms and lacked long-term objective measurements. This study aimed to estimate the pattern of chronic symptoms of Omicron reinfection in patients with original SARS-CoV-2 infection by comprehensively assessments 3 years after recovery.

Methods: This community-based observational study was conducted in Wuhan, China, between January and April in 2023. All participants were recruited from community and invited to participate the interview and examination in a hospital. The subjective multi-system symptoms were self-reported. The objective radiological features and laboratory data were assessed by measuring blood inflammation and performing chest computed tomography (CT) and pulse oxygen saturation.

Results: Among 1438 individuals who participated in the study, 144 were infected with the original variant only in 2020, 980 were Omicron-infected in 2023, 215 were reinfected both in 2020 and 2023, and 99 were never infected. Compared with the non-infection group, the reinfection (odds ratio (OR), 5.15 [95% confidence intervals (CIs), 2.96-8.96]) group was associated with the highest risk of any of chronic physical symptoms, followed by the Omicron infection (3.45 [2.19-5.44]) and original variant infection (2.90 [1.63-5.15]) groups. Compared with the non-infection group, the reinfection (4.05 [2.30-7.14]), Omicron infection (3.72 [2.26-6.11]), and original variant infection (2.71 [1.48-4.95]) groups were associated with an increased risk of any of chronic mental symptoms. Moreover, of all groups, the reinfection group reported the highest seropositivity rate for C-reactive protein, and the highest prevalence rates of ground glass opacities on chest CT and hypoxaemia.

Conclusions: Our results suggest that reinfection may be a risk factor for long COVID conditions. These findings provide information for the clinical management and healthcare services of long COVID and SARS-CoV-2 reinfection and highlight the importance taking necessary action to prepare for a future pandemic. The long-term follow-up will be needed to verify the impact of different SARS-CoV-2 infection status on long COVID in the future.